Japan’s largest Medicare Advantage insurance company presses to deny AI

Bob covers medical expenses with a focus on health insurance and hospitals. His story delves into Medicare Advantage, opaque prescription drug benefits, and what executives actually earn. He is also the author of the Health Care Inc. newsletter. You can reach Bob at Signal at bobjherman.09.

Sens. Richard Blumenthal (D-Conn.) and Josh Hawley (R-Missouri) are calling on the nation’s largest Medicare Advantage insurers to provide internal records and details about their use of artificial intelligence to block rehabilitation care.

The lawmakers’ request is a moment of bipartisan scrutiny of the controversial federal health care program and comes just a month after a government investigation revealed a persistent pattern of denials within Medicare Advantage.

In a letter provided to STAT, Blumenthal and Hawley told executives at UnitedHealth Group, Humana and CVS Health that recent findings from the Department of Health and Human Services Office of Inspector General undermine the companies’ claims that they have reduced barriers to critical health care services.